Provider Demographics
NPI:1902038342
Name:MIRANDA-SOTO, JANE (RN)
Entity Type:Individual
Prefix:MRS
First Name:JANE
Middle Name:
Last Name:MIRANDA-SOTO
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:COND TORES DE CERVANTES
Mailing Address - Street 2:APATAMENTO 713 A
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00924-3257
Mailing Address - Country:US
Mailing Address - Phone:787-902-8948
Mailing Address - Fax:
Practice Address - Street 1:COND TORES DE CERVANTES
Practice Address - Street 2:APATAMENTO 713 A
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00924-3257
Practice Address - Country:US
Practice Address - Phone:787-902-8948
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-19
Last Update Date:2009-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR7384163WP0807X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0807XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Child & Adolescent